Dermatology

Question 1

Primary skin lesion

Answer 1

Has not been altered by outside manipulation, treatment, natural course of disease. Ex- vesicles

Question 2

Secondary skin lesion

Answer 2

Lesions altered by outside manipulation, treatment, natural course of disease.
Ex- crust from ruptured vesicles, excoriation, lichenification, scales, erosion, ulcer, fissure

Question 3

Macule

Answer 3

Flat, non-palpable.

Question 4

Papule

Answer 4

Solid elevation,

Question 5

Pustule

Answer 5

Vesicle-like lesion with purulent content,

Question 6

Umbilicated

Answer 6

Papule with indented center

Question 7

Patch

Answer 7

Flat, non-palpable area of skin discoloration larger than a Macule. >1cm
Ex- vitiligo

Question 8

Plaque

Answer 8

Raised lesion, same or different color from surrounding skin, can result from a coalescence of papules >1cm
Ex- psoriasis vulgaris

Question 9

Bulla

Answer 9

Fluid-filled >1cm

Ex- 2nd degree burn (blister)

Question 10

Cyst

Answer 10

Raised, encapsulated, fluid filled lesion

Ex- intradermal cyst

Question 11

Wheal

Answer 11

Circumscribed area of skin edema

Ex- hives, ppd

Question 12

Purpura, petechiae

Answer 12

Flat red-purple discoloration that does not blanch with pressure.
>1cm= purpura

Question 13

Lichenification

Answer 13

Skin thickening usually found over pruritic or friction areas

Question 14

Confluent lesions

Answer 14

Multiple lesions blending together

Ex- psoriasis, tinea

Question 15

Annular lesions

Answer 15

In a ring, often seen in the characteristic “Bulls eye” lesion seen in Lyme disease

Question 16

Actinic keratoses

Answer 16

Brown, occasionally skin colored, scaly. Can be felt by running finger over area. Feels rough like Sand paper.
Most common precancerous skin lesion, can remain unchanged, spontaneously resolve, or progress to invasive squamous cell carcinoma.

Question 17

Basal cell

Answer 17

Most common, sun-exposed areas, arise on their own (de novo), pearly, waxy appearance, with relatively distinct borders.
Papule, nodule with or without central erosion

Mets risk low, significant tissue destruction risk without treatment.

Question 18

Squamous cell

Answer 18

Less common, can arise from nothing, KERATINIZING CELLS or AK’s.
Red, conical hard lesions with or without ulceration, less distinct borders.
Mets risk greater than BCC, (3-7%), significant tissue destruction without treatment. Greatest risk on lip, oral cavity, genitalia

Question 19

ABCDE of malignant melanoma

Answer 19

Asymmetric
Borders irregular
Color not uniform (brown, black, red, blue)
Diameter (usually >6mm)
Evolving new lesion or change in a lesion, particularly a nevus or other pigmented lesion.
Elevated

Question 20

Impetigo organisms

Answer 20

Staphylococcus aureus

Streptococcus pyrogenes

Question 21

Erysipelas definition & organisms

Answer 21

Hot, red, infection of the upper dermis, superficial lymphatics.

Streptococcus pyrogenes (requires IV Pcn)

Question 22

Cellulitis organisms

Answer 22

Streptococcus pyrogenes, less commonly staphylococcus aureus MSSA/MRSA

Question 23

Cutaneous abscess/furuncle, carbuncle organism

Answer 23

Staphylococcus aureus MSSA/ MRSA

Question 24

Treatment for cellulitis/erysipelas/impetigo

Answer 24

Moderate (systemically Ill, tracking/streaking)- IV penicillin, ceftriaxone IV, cefazolin IV, or clindamycin IV

Mild- pen VK, cephalexin, dicloxacillin, or clindamycin po

Question 25

Treatment of abscess/carbuncle/furuncle

Answer 25

Moderate (tracking/streaking, lymphadenopathy)- I&D, C&S, TMP/SMX or doxycycline Mild- I&D, no abt

Question 26

1st degree burn

Answer 26

Superficial burns- impacts epidermis only; no blisters present.

Question 27

2nd degree burn

Answer 27

Superficial partial thickness- upper layers of papillary dermis Deep partial thickness- deeper layers of dermis, including reticular dermis Blisters present

Question 28

3rd degree burns

Answer 28

Full thickness- epithelium, dermis & underlying fat layer.

Question 29

Body ringworm aka

Answer 29

Tinea corpois

Question 30

Jock itch aka

Answer 30

Tinea cruris

Question 31

Athletes foot aka

Answer 31

Tinea pedis

Question 32

Fungal infection of scalp aka

Answer 32

Tinea capitis

Question 33

Pityriasis rosea description & key findings

Answer 33

Oval, salmon-colored scaling plaques. Acute, exanthematous eruption. Classically starts with a HERALD PATCH secondary phase erupts in a CHRISTMAS TREE PATTERN

Question 34

Secondary syphilis rash

Answer 34

Looks similar to pityriasis rosea, but also presents on palms of hands & soles of feet. Order RPR to check for evidence of syphilis

Question 35

Psoriasis definition

Answer 35

Common, chronic, inflammatory mulit-system disease that mostly involves skin & joints Presents as classic pink to bright red WELL-DEMARCATED PLAQUES WITH SILVERY SCALE Usually on extensor knees & elbows

Question 36

Guttate psoriasis description

Answer 36

Presents as small "drop-like" scaly papules and plaques mostly on the trunk and extremities Often FOLLOWS GROUP A HEMOLYTIC STREPTOCOCCAL INFECTION

Question 37

Inverse/flexural psoriasis

Answer 37

Erythematous patches located in the skin folds (axilla, groin). May lack scale due to moistness of area. Often symmetric

Question 38

Pustular psoriasis

Answer 38

Psoriatic lesions with pustules Often TRIGGERED BY STEROID WITHDRAWAL when generalized, it can be life-threatening

Question 39

Palmoplantar psoriasis

Answer 39

May occur as plaque or pustular type. | Indistinguishable from rash of reactive arthritis

Question 40

Psoriatic erythroderma

Answer 40

Involves almost the entire skin surface. BRIGHT RED, hospitalization is sometimes required

Question 41

Auspitz sign

Answer 41

Bleeding after removal of scale (psoriasis scale)

Question 42

Koebner phenomenon

Answer 42

Psoriasis lesions induced by trauma

Question 43

Psoriasis treatment

Answer 43

Topical high potency steroids sometimes in combination with topical vitamin D analogs (topicals when

Question 44

Lice (head, body, pubic)

Answer 44

Head- pediculus humanus var. capitis Body- pediculus humanus var. corporis Pubic- phthirus pubis

Question 45

Pediculosis treatments

Answer 45

Permethrin 1% | Malathion 0.5% when resistance is suspected.

Question 46

Scabies (sarcoptes scabiei) features

Answer 46

Hallmark is ITCHING AT NIGHT | papules may commonly involve the axillae, breasts, umbilicus, penis, scrotum, finger web and wrists.

Question 47

Bed bug (cimex lectularius) treatment

Answer 47

Potent topical steroids and antihistamines